Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.66 / $66.20 / $149.60	Professional		$45.66	$66.20	$149.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.63 / $27.31 / $192.56	Professional	26	$16.63	$27.31	$192.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.64 / $43.02 / $79.88	Professional	TC	$31.64	$43.02	$79.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.19 / $20.39 / $29.11	Professional	26	$10.19	$20.39	$29.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.00 / $51.45 / $78.55	Professional		$49.00	$51.45	$78.55
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.39 / $62.50 / $66.31	Professional	26	$20.39	$62.50	$66.31
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.24 / $42.79 / $173.10	Professional	TC	$12.24	$42.79	$173.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.86 / $32.89 / $94.50	Professional		$29.86	$32.89	$94.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.17 / $13.56 / $61.13	Professional	26	$11.17	$13.56	$61.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.23 / $19.68 / $49.96	Professional	TC	$17.23	$19.68	$49.96
Medcost Facility/Professional Facility Modifier Low / Median / High Price $51.79 / $65.00 / $114.04	Facility		$51.79	$65.00	$114.04
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $26.11 / $39.00 / $70.00	Facility	26	$26.11	$39.00	$70.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.48 / $48.55 / $76.46	Professional		$25.48	$48.55	$76.46
United Facility/Professional Professional Modifier Low / Median / High Price $37.90 / $47.35 / $126.32	Professional		$37.90	$47.35	$126.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.22 / $15.98 / $52.07	Professional	26	$13.22	$15.98	$52.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.72 / $29.77 / $79.40	Professional	TC	$23.72	$29.77	$79.40